Provider Demographics
NPI:1295259018
Name:OURADA, DANNY (DC)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:OURADA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 OGDEN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1688
Mailing Address - Country:US
Mailing Address - Phone:630-778-2195
Mailing Address - Fax:
Practice Address - Street 1:3060 OGDEN AVE STE 201
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1688
Practice Address - Country:US
Practice Address - Phone:630-778-2195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-013048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor